Objective To develop and validate a"quick self-assessment questionnaire for cochlear implant out-come(QSACI)".Methods A research team,composed of audiologists,otolaryngologists,data analysis experts,and cochlear implant(CI)recipients,was formed to establish objectives,research subject criteria,and framework of the QSACI.An item pool was creaed through literature review and brainstorming.Question items were evaluated and screened,and the framework and answer options of the questionnaire were established.The comprehensibility,etc.,was analyzed and refined through pilot test,interviews,and expert consultation,leading to the development of the final version.A total of 39 post-lingually deafened adults with known stable outcomes completed the question-naire.The split-half and test-retest reliabilty of the questionnaire was analyzed,and the validity was quantitatively analyzed by comparing scores with the categories of auditory performance(CAP)scores.Results The initial item pool of the questionnaire had 18 items,and the final questionnaire consisted of 12 questions in four dimensions:com-munication status,audiological status,medical factors,and other factors.The average score of 39 recipients was 88.81±6.17 and CAP was 6.19±0.94.The questionnaire showed good reliability and validity,with a Cronbach's alpha coefficient of 0.71 and a test-retest reliability of 0.824(P＜0.05).The criterion-related validity,assessed by the correlation between the self-assessment questionnaire scores and CAP scores,showed a significant moderate pos-itive correlation(r=0.512,P＜0.05).The correlation coefficient between self-assessment and professional assess-ment was 0.720(P＜0.05),indicating a significant correlation.The area under the receiver operating characterstic(ROC)curve was 0.82(P＜0.05),the cutoff values corresponding to the maximal Youden index were 82.5 and 88.6,therefore score of 85 was taken as the median threshold score of judgement.Conclusion The QSACI reflects the post-imlplant outcomes,and it can serve as a tool for people with postlingually deafness and their families to un-derstand the eligbility of CI and the expected outcomes,helping to establish realistic expectations before CI surgery.

Objective To explore the value of Turbo-Flash mode CT scanning for displaying calcification of ligamentum arteriousum(CLA)in infants and young children.Methods Chest CT data obtained with Turbo-Flash mode scanning of 1 762 infants and young children(aged 1 to 36 months)with suspected lung,trachea or bronchi lesions were retrospectively analyzed.Children were divided into group A to L according to age at 3-month intervals.CLA was evaluated and its CT manifestations were analyzed.The incidence of CLA in each group was counted,the density of CLA was measured,and their correlations with age were observed.Results Among 1 762 children,912 was found with CLA(912/1 762,51.76%).The incidence of CLA in group A—L was 34.29%(12/35)—59.35%(92/155),respectively.All CLA located in the arterial ligaments between the left side of pulmonary trunk and the origin level of left subclavian artery of the aorta and shaped differently.The density of CLA in group A—L was(183.36±50.16)—(295.80±105.91)HU,respectively.The incidence of CLA in group A—F was positively(r=0.945,P=0.002),while in group F—L was negatively correlated with age(r=-0.765,P=0.045).Meanwhile,the density of CLA in group A—F was positively correlated with age(r=0.775,P=0.020),but no significant correlation between CLA density and age was found in G—L group(P=0.593).Conclusion Turbo-Flash mode CT scanning had high clinical application value for displaying CLA in infants and young children.

Objective To explore the value of Turbo-Flash mode CT scanning for displaying calcification of ligamentum arteriousum(CLA)in infants and young children.Methods Chest CT data obtained with Turbo-Flash mode scanning of 1 762 infants and young children(aged 1 to 36 months)with suspected lung,trachea or bronchi lesions were retrospectively analyzed.Children were divided into group A to L according to age at 3-month intervals.CLA was evaluated and its CT manifestations were analyzed.The incidence of CLA in each group was counted,the density of CLA was measured,and their correlations with age were observed.Results Among 1 762 children,912 was found with CLA(912/1 762,51.76%).The incidence of CLA in group A—L was 34.29%(12/35)—59.35%(92/155),respectively.All CLA located in the arterial ligaments between the left side of pulmonary trunk and the origin level of left subclavian artery of the aorta and shaped differently.The density of CLA in group A—L was(183.36±50.16)—(295.80±105.91)HU,respectively.The incidence of CLA in group A—F was positively(r=0.945,P=0.002),while in group F—L was negatively correlated with age(r=-0.765,P=0.045).Meanwhile,the density of CLA in group A—F was positively correlated with age(r=0.775,P=0.020),but no significant correlation between CLA density and age was found in G—L group(P=0.593).Conclusion Turbo-Flash mode CT scanning had high clinical application value for displaying CLA in infants and young children.

Objective To study the correlation between expression levels of serum Spexin and Pannexin 1 protein,glucose and lipid metabolism and insulin resistance in elderly patients with diabetic cataract.Methods A total of 118 elderly diabetic cataract patients were selected as the case group,and 103 elderly diabetic non-cataract patients were selected as the control group who were treated in the same hospital during the same period.Serum levels of Spexin and Pannexin1 were detected by enzyme-linked immunosorbent assay(ELISA).Fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)were measured.Lipid metabolism related indicators including triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were detected in two groups of patients.Insulin resistance related indexes:fasting insulin(FINS),insulin sensitivity index(ISI),insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-β)were also detected.The correlation between serum Spexin and Pannexin1 levels,glucolipid metabolism and ISI was detected by Pearson method.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum Spexin and Pannexin1 levels and their combination in the development of cataract in elderly diabetic patients.Results The level of Spexin was lower in the observation group than that in the control group,and the level of Pannexin1 was higher than that in the control group(P＜0.01).Levels of TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR of the observation group increased compared with the control group,while HDL-C,ISI and HOMA-β levels decreased compared with the control group(P＜0.01).Pearson correlation analysis showed that serum Spexin level was positively correlated with ISI and HOMA-β,and negatively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR in elderly patients with diabetic cataract(P＜0.05).Serum Pannexin1 was negatively correlated with ISI and HOMA-β,and positively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR(P＜0.05).There was no correlation between the above indexes and HDL-C(P＞0.05).The combination of both serum Spexin and Pannexin1 predicted the development of cataracts in elderly diabetic patients was better than serum Spexin and Pannexin1 assessed individually(Z both combination-Spexin=3.220,P=0.001,Z both combination-Pannexin1=4.838,P＜0.001).Conclusion In elderly patients with diabetic cataract,the expression of serum Spexin decreases and the expression of Pannexin1 increases,and they have a certain correlation with glucose and lipid metabolism and insulin resistance

Objective To develop and validate a"quick self-assessment questionnaire for cochlear implant out-come(QSACI)".Methods A research team,composed of audiologists,otolaryngologists,data analysis experts,and cochlear implant(CI)recipients,was formed to establish objectives,research subject criteria,and framework of the QSACI.An item pool was creaed through literature review and brainstorming.Question items were evaluated and screened,and the framework and answer options of the questionnaire were established.The comprehensibility,etc.,was analyzed and refined through pilot test,interviews,and expert consultation,leading to the development of the final version.A total of 39 post-lingually deafened adults with known stable outcomes completed the question-naire.The split-half and test-retest reliabilty of the questionnaire was analyzed,and the validity was quantitatively analyzed by comparing scores with the categories of auditory performance(CAP)scores.Results The initial item pool of the questionnaire had 18 items,and the final questionnaire consisted of 12 questions in four dimensions:com-munication status,audiological status,medical factors,and other factors.The average score of 39 recipients was 88.81±6.17 and CAP was 6.19±0.94.The questionnaire showed good reliability and validity,with a Cronbach's alpha coefficient of 0.71 and a test-retest reliability of 0.824(P＜0.05).The criterion-related validity,assessed by the correlation between the self-assessment questionnaire scores and CAP scores,showed a significant moderate pos-itive correlation(r=0.512,P＜0.05).The correlation coefficient between self-assessment and professional assess-ment was 0.720(P＜0.05),indicating a significant correlation.The area under the receiver operating characterstic(ROC)curve was 0.82(P＜0.05),the cutoff values corresponding to the maximal Youden index were 82.5 and 88.6,therefore score of 85 was taken as the median threshold score of judgement.Conclusion The QSACI reflects the post-imlplant outcomes,and it can serve as a tool for people with postlingually deafness and their families to un-derstand the eligbility of CI and the expected outcomes,helping to establish realistic expectations before CI surgery.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

Objective:To compare the clinical effect of femoral neck system (FNS) and cannulated compression screw internal fixation in the treatment of femoral neck fractures in young and middle-aged patients.Methods:The databases of CNKI, Wanfang Data Knowledge Service Platform, VIP, Chinese Medical Journal Full-text Database, PubMed, Embase, Web of Science and Cochrane Library were searched. The intraoperative blood loss, intraoperative fluoroscopy times, hospital stay, fracture healing time, Harris hip function score, partial weight-bearing time and complication rate were extracted to compare the clinical efficacy of the two surgical methods. Stata18.0 statistical software was used for meta-analysis.Results:A total of 699 patients from 11 studies were included in this study. Compared with cannulated compression screw internal fixation, the FNS had a shorter operation time [ WMD= -8.54, 95% CI(-14.87, -2.21), P=0.008], fewer intraoperative fluoroscopy times[ WMD= -8.29, 95% CI(-11.45, -5.12), P< 0.001], a shorter fracture healing time [ WMD=-1.59, 95% CI(-2.49, -0.68), P=0.001], a shorter partial weight-bearing time[ WMD=-3.45, 95% CI(-4.43, -2.46), P<0.001], a lower incidence of postoperative complications [ RR=0.41, 95% CI(0.22, 0.76), P= 0.004], and a lower incidence of postoperative nonunion [ RR=0.40, 95% CI(0.18, 0.88), P=0.022]. Meanwhile, the FNS group had more intraoperative blood loss [ WMD=9.53, 95% CI(2.70, 16.35), P=0.006] and a higher Harris hip function score at the last follow-up [ WMD=3.50, 95% CI(2.11, 4.89), P<0.001] than the cannulated compression screw internal fixation group. There were no statistically significant differences in the length of hospital stay [ WMD=-0.48, 95% CI(-0.82, -0.13), P=0.092] or the incidence of femoral head necrosis [ RR=0.57, 95% CI(0.26, 1.24), P=0.159] between the two groups. Conclusion:Compared with cannulated compression screw internal fixation in the treatment of femoral neck fracture in young and middle-aged patients, FNS has more intraoperative blood loss, but it has more advantages in operation time, intraoperative blood loss, intraoperative fluoroscopy times, postoperative fracture healing time, Harris hip function score, partial weight-bearing time, postoperative nonunion rate and postoperative complications rate.

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

With the continuous advancements in immunotherapy and targeted therapy, the treatment management and surgical resection assessment of locally advanced lung cancer have undergone significant changes. In October 2024, the Society of Thoracic Surgeons (STS) released the "STS expert consensus on the multidisciplinary management and resectability of locally advanced non-small cell lung cancer", which provides the latest insights on the evaluation of resectability and multidisciplinary management of locally advanced lung cancer, neoadjuvant (including perioperative) therapy, and adjuvant therapy. This article aims to interpret this consensus, with the goal of introducing the latest perspectives of the STS consensus to thoracic surgeons and providing a reference for the rational implementation of surgical resection, multidisciplinary management, and standardized comprehensive treatment models for non-small cell lung cancer in China.

Minimally conscious state （MCS） is at the edge between closed and open consciousness， but it still belongs to the category of "wind-strike block" syndrome. The basic pathogenesis of MCS is the obstruction of pathogenic qi， orifices closed and spirit hidden， with pathological factors including phlegm， fire， and blood stasis. Wind movement and water retention may also be present， and often leading to deficiency syndrome due to the exhaustion of qi， blood， yin， and yang at later stages. Treatment chooses Shexiang （Moschus） as the chief medicinal， emphasizing combination of medicinals and urgency of medication administration； the key therapeutic method is to open the orifices， with focuses on expelling pathogens and reinforcing healthy qi. For patients with severe phlegm or fire， use Xiaochengqi Decoction （小承气汤） to open the lower orifices， discharge heat and unblock the bowels， combined with Shexiang （Moschus） and Niuhuang （Bovis Calculus） to open the upper orifices， awaken the spirit and guide qi. For patients with turbid phlegm as the predominant， temporarily replace Shexiang （Moschus） with Baizhi （Angelicae dahuricae radix）， using Ditan Decoction （涤痰汤） to eliminate phlegm to open the orifices， when turbid phlegm gradually subsided， Shexiang （Moschus） could be added. For patients with blood stasis as the predominant， Tongqiao Huoxue Decoction （通窍活血汤） will be used to activate blood and open orifice， if the blood circulates， the endogenous wind will be calmed， the water will be induced， the orifices will open and the consciousness will restore. For patients with closed orifices and body deficiency， the treatment should open the orifices and reinforce healthy qi， and consider the root and branch simultaneously； qi deficiency syndrome can be addressed with Buyang Huanwu Decoction （补阳还五汤） to boost qi and reinforce healthy qi； yin deficiency syndrome can be treated with Shaoyao Gancao Decoction （芍药甘草汤） combined with Fengsui Pill （封髓丹） to nourish yin， soften sinews， and secure kidney essence； yang deficiency can be managed by using Dihuang Yinzi Decoction （地黄饮子） to enrich yin， supplement yang， and open the orifices.